Pain Relief in Neonates

It is the basic right of every individual, irrespective of age or size, to have alleviation of pain. Pain in newborn infants is a ubiquitous phenomenon. All newborns, even normal ones, will experience iatrogenic pain in the first days of life, commencing with vitamin K injection and blood collection for sugars, bilirubin or metabolic screening before discharge from the hospital. Neonates admitted to present day neonatal intensive care units (NICU) are constantly exposed to pain, discomfort or noxious stimuli of variable intensity for a variety of reasons. These include major surgical procedures, needle pricks for blood drawing and cannulations. The painful situation may be short lived or chronic as in the case of necrotizing enterocolitis and prolonged ventilation. Even apparently innocuous care giving procedures like diaper changes, daily weighing and removal of adhesive tape results in noxious stimuli. All these events, especially in preterm infants individually or cumulatively, result in adverse sequelae in the form of death, poor neurologic outcomes, abnormal somatization and response to pain later in life.